Hostname: page-component-6766d58669-kn6lq Total loading time: 0 Render date: 2026-05-18T23:33:48.635Z Has data issue: false hasContentIssue false
  • English
  • Français

Pre-operative prediction of ‘dry taps’

Published online by Cambridge University Press:  21 April 2008

S Henney ,
P Counter ,
S Mirza ,
P Gedling  and
C Watson
S Henney*
Affiliation:
Senior House Officer, Department of Otolaryngology Head & Neck Surgery, Cumberland Infirmary, Carlisle, UK
P Counter
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Specialist Registrar James Cook Hospital, Middlesbrough, UK
S Mirza
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Specialist Registrar James Cook Hospital, Middlesbrough, UK
P Gedling
Affiliation:
Department of Otolaryngology Head & Neck Surgery, Statistician Bishop Auckland General Hospital, Bishop Auckland, UK
C Watson
Affiliation:
Consultant ENT Surgeon ENT Department, Darlington Memorial Hospital, UK
*
Address for correspondence: Mr S Henney, ENT Dept., City Hospital, Dudley Road, Birmingham, Wesd Midlands, B18 7QH Fax:  +44 (0)121 353 5432 E-mail: scott.henney@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

The treatment of children with ‘glue ear’ often presents surgeons with the question of whether or not to insert a grommet when myringotomy reveals no fluid in the middle ear. We present a study designed to assess which factors contribute to the presence of a ‘dry tap’.

Design:

We prospectively gathered data from a cohort of 280 children (504 myringotomies). The cohort included two subgroups, one received halothane and nitrous oxide anaesthesia, and the other received enflurane anaesthesia.

Setting:

The ENT department of a district general hospital.

Participants:

Children (aged less than 17 years) requiring myringotomy.

Main outcome measures:

The presence of a ‘glue’ or dry tap at myringotomy was documented. We also recorded data on the following: pre- and post-induction tympanometry; age; season; anaesthetic type; and the delay from listing to actual operation.

Results:

A non type B pre-induction tympanogram and delay to operation were strong indications of finding a dry tap at surgery.

Conclusions:

In our study population, the proportion of dry taps at myringotomy was 18 per cent. The presence of a dry tap was rarely due to the induction of anaesthesia. Multivariate analysis revealed that the combination of factors most likely to predict a dry tap were non type B tympanogram and delay to operation.

Keywords

Otitis Media With EffusionVentilation TubesImpedance Audiometry

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 1 , January 2009 , pp. 61 - 68
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1 Rees, GL, Freedland, AP. The effect of anaesthesia on tympanograms of children undergoing grommet insertion. Clin Otolaryngol 1992;17:200–2CrossRefGoogle ScholarPubMed
2 Black, NA, Sandeson, CF, Freeland, AP. A randomised controlled trial of surgery for glue ear. BMJ 1990;300:1551–6CrossRefGoogle ScholarPubMed
3 Drake-Lee, AB, Casey, WF, Ogg, TW. Anaesthesia for myringotomy. Anaesthesia 1983;38:314–18CrossRefGoogle ScholarPubMed
4 Drake-Lee, AB, Casey, WF. Anaesthesia and tympanometry. Int J Pediatr Otorhinolaryngol 1983;6:171–8Google ScholarPubMed
5 Gordon, MA, Grunstein, E, Burton, WB. The effect of the season on otitis media with effusion resolution rates in the New York metropolitan area. Int J Pediatr Otorhinolaryngol 2004;68:191–5CrossRefGoogle ScholarPubMed
6 MRC multi-centre otitis media study group. Risk factors for persistence of bilateral otitis media with effusion. Clin Otolaryngol 2001;26:147–56CrossRefGoogle Scholar
7 Kogan, MD, Overpeck, MD, Hoffman, HJ. Factors associated with tympanostomy tube insertion amongst preschool-aged children in the United States. Am J Public Health 2000;90:245–50Google Scholar
8 Daly, KA, Hunter, LL, Lindgren, BR. Chronic otitis media with effusion sequelae in children treated with tubes. Arch Otolaryngol Head Neck Surg 2003;129:517–22CrossRefGoogle ScholarPubMed
9 Hoffman, KK, Thompson, KG, Burke, BL. Anesthetic complications of tympanostomy tube placement in children. Arch Otolaryngol Head Neck Surg 2002;128:1040–3CrossRefGoogle Scholar
10 Kacmarynski, DSF, Levine, SC, Pearson, SE. Complications of otitis media before placement of tympanostomy tubes in children. Arch Otolaryngol Head Neck Surg 2004;130:289–92CrossRefGoogle ScholarPubMed
11 Effective Health Care; The Treatment of Persistent Glue Ear in Children No. 4. Leeds: University of Leeds, 1992Google Scholar
12 Fiellau-Nikolajsen, M. Tympanometry and secretory otitis media. Acta Otolaryngol 1983;394:1–73Google ScholarPubMed
13 Jardine, AH, Maw, AR, Coulton, S. Dry tap at myringotomy: a three year study of 1688 children undergoing myringotomy. Clin Otolaryngol 1999;24:266–9CrossRefGoogle ScholarPubMed
14 Shaw, JO, Stark, EW, Gannaway, SD. The influence of nitrous oxide anaesthetic on middle-ear fluid. J Laryngol Otol 1978;92:131–5CrossRefGoogle ScholarPubMed
15 Zielhuis, GA, Heuvelmans-Heinen, EW, Rach, GH. Environmental risk factors for otitis media with effusion in pre-school children. Scand J Prim Health Care 1989;7:33–8CrossRefGoogle Scholar
16 Lim, D. Early and late effects of surgery for otitis media with effusion. Recent Advances in Otitis Media 1988;282–5Google Scholar
17 Maw, A, Parker, A. Surgery of the tonsils and adenoids in relation to secretory otitis media in children. Acta Otolaryngol Suppl 1988;454:202–7CrossRefGoogle ScholarPubMed
18 Singh, CB, Kirk, R. The effect of nitrous oxide on middle ear pressure in children. J Laryngol Otol 1979;93:349–56CrossRefGoogle ScholarPubMed
19 Marshall, FPF, Cable, HR. The effect of nitrous oxide on middle-ear effusions. J Laryngol Otol 1982;96:893–7CrossRefGoogle ScholarPubMed
20 Koivunen, P, Alho, OP, Uhari, M. General anesthesia with and without nitrous oxide (N2O) and the weight of middle ear effusion in children undergoing adenoidectomy and tympanostomy. Laryngoscope 1996;106:724–6CrossRefGoogle ScholarPubMed
21 Finitzo, T, Friell-Patti, S, Chinn, K. Tympanometry and otoscopy prior to myringotomy: issues in diagnosis of otitis media. Int J Pediatr Otorhinolaryngol 1992;24:101–10CrossRefGoogle ScholarPubMed
22 Watters, GWR, Jones, JE, Freeland, AP. The predictive value of tympanometry in the diagnosis of middle ear effusion. Clin Otolaryngol 1997;22:343–5CrossRefGoogle ScholarPubMed
23 Kazanas, SG, Maw, AR. Tympanometry, stapedius reflex and hearing impairment in children with otitis media with effusion. Acta Otolaryngol 1994;114:410–14CrossRefGoogle ScholarPubMed